Signet ring cell

High magnification micrograph showing signet ring cells, with clear cytoplasm, in metastatic breast carcinoma. H&E stain.

Signet ring cells (magenta) stained with PAS in a gastric signet ring cell carcinoma.

Gastric signet ring cell carcinoma. H&E stain.

In histology, a signet ring cell is a cell with a large vacuole, the malignant type is seen predominantly in carcinomas.

Signet ring cells are most frequently associated with stomach cancer,^[1] but can arise from any number of tissues including the prostate,^[2] bladder, gallbladder,^[3] breast, colon,^[4] ovarian stroma and testis.^[5]

Types

The NCI Thesaurus identifies the following types of signet ring cell

• Castration cell, a non-malignant cell arising in the anterior pituitary gland under certain abnormal hormonal conditions.
• Neoplastic thyroid gland follicular signet ring cell
• Signet ring adenocarcinoma cell
• Signet ring melanoma cell
• Signet ring stromal cell

Appearance

The name of the cell comes from its appearance; signet ring cells resemble signet rings. They contain a large amount of mucin, which pushes the nucleus to the cell periphery. The pool of mucin in a signet ring cell mimics the appearance of a finger hole and the nucleus mimics the appearance of the face of the ring in profile.

Diagnostic significance

A significant number of signet ring cells, generally, are associated with a worse prognosis.^[6][7]

Classification of carcinomas

SRC carcinomas can be classified using immunohistochemistry.^[8]

See also

• Signet ring cell carcinoma

References

1. ↑ Cancer Research UK. Signet Ring Cancer. cancerhelp.org.uk. URL: http://www.cancerhelp.org.uk/help/default.asp?page=7581. Accessed on: November 2, 2007.
2. ↑ Leong FJ, Leong AS, Swift J (1996). "Signet-ring carcinoma of the prostate". Pathol. Res. Pract. 192 (12): 1232–8; discussion 1239–41. doi:10.1016/S0344-0338(96)80156-7. PMID 9182294. 
3. ↑ Jain V, Gupta K, Kudva R, Rodrigues GS (2006). "A case of ovarian metastasis of gallbladder carcinoma simulating primary ovarian neoplasm: diagnostic pitfalls and review of literature". Int. J. Gynecol. Cancer. 16 Suppl 1: 319–21. doi:10.1111/j.1525-1438.2006.00335.x. PMID 16515613. 
4. ↑ Makino T, Tsujinaka T, Mishima H, et al. (2006). "Primary signet-ring cell carcinoma of the colon and rectum: report of eight cases and review of 154 Japanese cases". Hepatogastroenterology 53 (72): 845–9. PMID 17153438. 
5. ↑ Michal M, Hes O, Kazakov DV (2005). "Primary signet-ring stromal tumor of the testis". Virchows Arch. 447 (1): 107–10. doi:10.1007/s00428-005-1218-2. PMID 15909171. 
6. ↑ Lee WS, Chun HK, Lee WY, et al. (2007). "Treatment outcomes in patients with signet ring cell carcinoma of the colorectum". Am. J. Surg. 194 (3): 294–8. doi:10.1016/j.amjsurg.2006.12.041. PMID 17693269. 
7. ↑ Cabebe EC, Mehta VK, Fisher G. Gastric Cancer. eMedicine.com. URL: http://www.emedicine.com/med/topic845.htm. Accessed on: November 8, 2007.
8. ↑ Tian MM, Zhao AL, Li ZW, Li JY (2007). "Phenotypic classification of gastric signet ring cell carcinoma and its relationship with clinicopathologic parameters and prognosis". World J. Gastroenterol. 13 (23): 3189–98. PMID 17589897. 

External links

• Signet ring cells - med.Utah.edu.
• Signet ring cell definition - cancer.gov.
• Signet ring cell cancer information - sites.google.com/site/signetringcancer.